Form Bl001 - Business License Application Page 2

Download a blank fillable Form Bl001 - Business License Application in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Bl001 - Business License Application with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

BUSINESS OWNERSHIP

Name (Last, First):

Home Address:

Title:

Percent Owned:

P.O. Box Not

Acceptable:

Email:

Date of Birth:

Home Phone:

Cell Phone:

Name (Last, First):

Home Address:

Title:

Percent Owned:

P.O. Box Not

Acceptable:

Email:

Date of Birth:

Home Phone:

Cell Phone:

Name (Last, First):

Home Address:

Title:

Percent Owned:

P.O. Box Not

Acceptable:

Email:

Date of Birth:

Home Phone:

Cell Phone:

PREVIOUS BUSINESS INFORMATION - Name, Address & Ownership (if application is for a change of business name, location, or ownership)

20 ACKNOWLEDGEMENT

1. I am aware that any changes to this business must be reported within 15 days. Business closure must be received in writing or additional fees and penalties will apply.

2. Outstanding business license fees must be paid prior to making any changes to the business. All unpaid balances must be paid prior to closing. Any unpaid balance may be subject to additional fees

and/or collections. If notice is given after the renewal date of a license, the licensee may still be responsible for all renewals fees. The purchaser of any existing business license is responsible to

ensure all outstanding licensee fees and any unpaid fees discovered in audits of prior billing cycles are paid in full.

3. I have informed all owners, managers, or other principals of their criminal and/or civil responsibility for the timely fulfillment of all restrictions and conditions to the license or timely abatement of

any nuisance activity at or associated with the business, per LVMC 6.02.080.

4. I accept the license subject to all of the terms and provisions of this Title and that the license is a privilege conferred upon the person who is granted the license.

5. If a background check is required I authorize the City of Las Vegas to obtain information from criminal justice agencies, financial institutions, Federal, State and local governments and agencies, and

other persons and entities and shall consent to the release of such information to the City for use in connection with the application for the license and other City business regulations.

6. I release the City of Las Vegas from all claims and hold-harmless the City for its use of the information provided by the applicant or discovered during any investigation thereof.

7. I understand that if my business requires a health permit, it is unlawful to operate without a valid permit issued by the health authority.

8. I acknowledge that several business license categories require Nevada state licenses. All such principals are aware that failure to maintain required Nevada state business licenses renders a City of

Las Vegas business license invalid and thereafter any business activity would be unlawful.

9. As an authorized agent of the entity identified in this application, I certify that I have reviewed the above requirements and that the information provided in this application is true, correct, complete

and current to the best of my knowledge and belief.

I ACKNOWLEDGE THAT I HAVE MADE COPIES OF ALL DOCUMENTS SUBMITTED TO KEEP FOR MY RECORDS AS PART OF THIS APPLICATION PROCESS.

21 I certify that I am the owner / applicant and I acknowledge the conditions of licensing and agree to all terms and acknowledgements.

Authorized Signature:

Print Name:

Date:

Authorized Agent:

Phone:

Fax:

E-mail:

FOR CITY OF LAS VEGAS USE ONLY

Fee Type